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NPI Code Detail

MEDICARE: JUSTIN J MCHUGH DDS

MEDICARE: JUSTIN J MCHUGH DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice DentistryD11518MN

General Provider Information

NPI Number : 1073687109
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUSTIN J MCHUGH DDS
Provider Business Mailing Address
First Line : 11601 MINNETONKA MILLS RD
Second Line :
City : MINNETONKA
State : MN
Zip : 55305-5161
Country : US
Telephone Number : 952-938-8858
Fax Number : 952-938-1992
Provider Business Practice Location Address
First Line : 11601 MINNETONKA MILLS RD
Second Line :
City : MINNETONKA
State : MN
Zip : 55305-5161
Country : US
Telephone Number : 952-938-8858
Fax Number : 952-938-1992
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/20/2006
Last Update Date : 07/08/2007

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